Objective: To compare the similarity in how youth in the United States, Australia, and Britain appraise anti-smoking advertisements with different characteristics.
Design: Each participant viewed and evaluated a set of 10 anti-smoking adverts (from an overall total of 50 adverts) in a controlled experimental context using an audience response methodology. A structured telephone interview was completed one week after viewing the adverts, in which recall and engagement with the adverts by participants was evaluated.
Subjects: 615 youths who were experimenting with smoking or were susceptible nonsmokers.
Main outcome measures: Measures of advert appraisal and engagement.
Results: Youth in the United States, Australia, and Britain responded in very similar ways to the same anti-smoking advertisements. In full multivariate models, the target audience of the advert and the advert theme were not related to the main outcome measures employed in this study. However, adverts with visceral negative or personal testimonial executional characteristics were appraised more positively by youths and were more likely to be recalled, thought about, and discussed at follow up one week later.
Conclusions: Youths in three different countries responded to anti-smoking advertisements in very similar ways, suggesting that such adverts might be more actively shared among nations. The appraisal of, and engagement with, the anti-smoking adverts, however, varied substantially depending on executional characteristics. In the design of effective anti-smoking adverts, due attention needs to be paid to those characteristics that appear to most engage youth across different social and cultural environments.

A good deal of evidence now indicates that anti-smoking advertising can be effective in reducing levels of smoking among youth.1–5 Anti-smoking advertising has been a prominent component of tobacco control initiatives in the United
States and has been associated with declines in smoking prevalence among both youth and adults in the States where such advertising has been employed.1 6 7 The use of antismoking advertising has also been an important element of tobacco control efforts in Australia since the early 1980s. These advertisements, which have most recently depicted in graphic detail the adverse health consequences of smoking, have generated high public awareness and positive responses among both youth and adults.8–11 Tobacco control programmes in
Britain have also employed anti-smoking advertising with some success.12
However, not all anti-smoking advertisements are equal in terms of their efﬁcacy in changing smoking related beliefs, attitudes, and behaviours. Indeed, a number of studies have failed to ﬁnd a relationship between anti-smoking advertising and reductions in tobacco prevalence.2–4 Clearly it is important to establish the characteristics of adverts and marketing strategies that are best able to advance tobacco control objectives. Opinions vary, however, regarding just what sorts of adverts are most likely to reduce smoking among youth. Pechmann and Reibling13 suggest that messages that emphasise
harm

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